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Biomedical subjects

F Grunenberger

Publications and source records attributed to F Grunenberger.

53 records · Page 3Linked to original sources
PubMed1996

Food patterns of elderly Europeans. SENECA Investigators.

OBJECTIVE: To compare actual food intake of elderly people in Europe and further identify food patterns, which mediate favourable or unfavourable nutrient intakes from cluster analysis of pooled data. DESIGN: Cross-sectional analysis of food patterns of participants of the SENECA follow-up study (1993). SETTING: Twelve traditional European towns. SUBJECTS: Men (n = 647) and women (n = 710) aged 74-79 y in 1993. METHODS: Food intake data were assessed using the same validated dietary history technique in all SENECA towns. Cluster analysis was used to classify subjects into groups based on similarities in dietary variables. RESULTS: A northern and southern European eating pattern emerged. The southern food pattern appeared to be the most healthful being rich in grain, vegetables, fruit, lean meat and olive oil. The north-south gradient did, however, not systematically segregate into the same clusters. All dietary profiles were represented in all sites. The four dietary profiles, identified by cluster analysis, were: 'Lean and green eaters': high carbohydrate and vitamin C intake, 'gourmands': high intake of energy and nutrients, 'milk drinkers': high intake of calcium and vitamin B2 and 'small eaters': marginal energy and nutrient consumption. Marital status, education, smoking, health status and physical activity level differed between clusters. CONCLUSIONS: A north-south gradient of food patterns was identified. The southern diet agreed better with guidelines for healthy eating. A sufficient energy intake seemed, however, to be necessary for an adequate nutrient intake, beside a good choice of food types.

Aged↗
PubMed1995

Low cholesterol concentrations in free-living elderly subjects: relations with dietary intake and nutritional status.

Hypocholesterolemia has been reported in epidemiologic studies to be associated with increased mortality from noncardiovascular causes. Low cholesterol concentrations have been reported in various pathologic conditions and in institutionalized elderly patients, and seem to be associated with poor outcome. The role of nutritional factors in the genesis of hypocholesterolemia was investigated in 380 free-living elderly subjects. Subjects in the lowest cholesterol quartile had lower free triidothyronine and prealbumin concentrations and a lower Folstein's score (a minimental test) than did those in the other quartiles. They did not differ from the other subjects for energy or nutrient intakes. Only 12 subjects (9 men and 3 women) had cholesterol concentrations < 3.62 mmol/L: the men had low free triidothyronine, free thyroxine, and prealbumin concentrations but normal energy and nutrient intakes, whereas the women differed from those with normal cholesterol concentrations for biological and nutritional data. These results indicate that low cholesterol concentration is a nonspecific feature of poor health status that is independent of nutrient or energy intake. The role of nutrient factors as a determinant of cholesterol concentration appears marginal in free-living elderly subjects.

Aged↗
PubMed1995

Nutrition of the elderly: a challenge between facts and needs.

Interactions between nutrition and the ageing process are a fascinating field of research. The assessment of the nutritional status is an important part of medical examination. Generally it is assumed that energy intake and energy expenditure decrease with age. In fact they vary widely and are very different in healthy, in sick or in institutionalized elderly. Nutritional requirements depend on many social and physiological factors in the free-living elderly population. Surveys indicate that dietary requirements are qualitatively grossly comparable to those in middle-aged adults. However the elderly are particularly at risk of marginal deficiencies of vitamins and trace elements. Today the early recognition of malnutrition is an important challenge. Its prevention may influence the evolution of nonspecific intercurrent disease and restore immunocompetence. Another challenge is to promote health by adequate recommendations in order to prevent deficiency diseases and to increase longevity. Some studies suggest that nutrition-based preventive medicine remains useful in the elderly. Caloric restriction, weight loss in case of obesity, decrease in blood lipids, increase in calcium intake which depend mainly of prior nutritional habits may have an effect in the elderly. However, prevention of protein caloric malnutrition is more relevant in the elderly.

Aged↗
PubMed1994

Thyroid hormone status and nutrient intake in the free-living elderly. Interest of reverse triiodothyronine assessment.

Fasting or hypercaloric diets are established methods of inducing low triiodothyronine (T3) levels that resemble the sick euthyroid syndrome in adults, but little is known on the mechanisms of this syndrome in the elderly. Decreasing T3 does not seem to be an unavoidable consequence of ageing, but the role of illness or other factors in this decline remains unclear. The aim of this work was to study the influence of nutritional factors on thyroid hormone levels in free-living elderly subjects. A 3-day dietary survey was conducted in 440 randomized subjects aged between 65 and 96. Cholesterol, apoproteins, prealbumin, hemoglobin, thyrotropin-free thyroxine (FT4), FT3 and reverse T3 (rT3) were assayed in each subject. Only 11 subjects had low FT3 levels, and they also had low levels of cholesterol, prealbumin and hemoglobin and a lower Folstein score compared to the rest of the population. Twenty-one subjects had isolated elevated rT3 levels, they were older and had significantly lower energy and fat intakes than the rest of the population. There was a clear reduction in FT3 levels and an increase in rT3 levels with age, although in the normal ranges, which occurred despite maintenance of a high-energy intake even in the oldest group. The FT3 level was lower in the subjects with poor health status, whereas high rT3 levels were associated with low energy intake in men. Stepwise regression showed that hemoglobin, age and prealbumin were the best predictors of FT3 levels, whereas age and energy intake were the main predictors of rT3 levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

[Left ventricular filling in young insulin-dependent diabetics].

Left ventricular function indices were measured by pulsed Doppler-echocardiography in 17 young patients (mean age: 25 +/- 5) with insulin-dependent diabetes and 17 controls (identical mean age: 25 +/- 5) free of heart disease. All subjects had normal left ventricular systolic function. Twenty three per cent of diabetics showed a left ventricular filling anomaly on the basis of at least two abnormal indices. Isovolumic relaxation time was significantly prolonged in diabetics as compared with normal individuals (83 +/- 7 v. 68 +/- 9 ms, p < 0.00015). Half-pressure time was also prolonged in the patients (46 +/- 9 v. 38 +/- 6 ms, p < 0.01), the same applying to rapid filling deceleration time (158 +/- 32 v. 136 +/- 29 ms, p < 0.05). Peak rapid filling rate, the proportion of total filling accounted for by rapid filling, peak atrial systole velocity and the atrial contribution to total filling did not differ between the diabetics and controls. Systolic blood pressure was significantly higher in diabetics as compared with controls (124 +/- 8 v. 114 +/- 10 mmHg, p = 0.007), although remaining within normal limits. This would not, however, explain the differences seen between the 2 groups regarding left ventricular profile. The filling anomalies reported here were not correlated with the duration of diabetes nor with other parameters such as glycosylated hemoglobin or 24-hour microalbuminuria. Our results suggest that approximately 20 p. cent of young diabetics have sub-clinical left ventricular anomalies.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Calcitonin gene-related peptide (CGRP): a vasodilator neuropeptide with many potential applications].

CGRP (calcitonin gene-related peptide) is a potent vasodilator neuropeptide which acts on peri-arteriolar neurones and is implicated in the pathogenesis of numerous cardiovascular diseases. The synthesis of CGRP antagonists should be useful for the treatment of Raynaud's disease as well as migraine. There exists an homology between the structures of CGRP and pancreatic amylin and therefore an eventual role of CGRP in type II diabetes pathophysiology is currently being studied.

Aldosterone↗
PubMed1993

[Thyrotropin assay by chemiluminescence in the diagnosis of dysthyroidism with low thyrotropin and normal thyroid hormones levels].

The performances of a new "3rd generation" chemoluminescence TSH assay (TSH ICMA) with a functional sensitivity of 0.005 mU/l were compared with those of an "ultrasensitive" TSH immunoradiometric assay (TSH IRMA) in a series of patients characterised by a TSH IRMA less than 0.20 mU/l and normal free thyroxin (T4 L) and triiodothyronine (T3 L) concentrations. The 95% cut-off value for hyperthyroidism was 0.03 for TSH ICMA and 0.05 for TSH IRMA. In a first group of 41 subjects undergoing Tc99m thyroid scan, images of multifocal increased uptake or toxic adenoma were associated with a lower TSH ICMA than in patients with a normal isotope scan. TSH ICMA was also lower than TSH IRMA (p < 0.01). At the cut-off value of 0.03 mU/l, the specificity of TSH ICMA was higher than that of TSH IRMA, but the sensitivity were identical. In a second group of 36 patients with severe non-thyroid diseases, TSH ICMA was lower than the cut-off value for hyperthyroidism in 30% of cases, while TSH IRMA was lower than the cut-off value in 40% of cases. A satisfactory concordance was observed between the two methods. In conclusion, the two TSH assays, IRMA and ICMA, provide globally comparable information in subjects with a low TSH and normal T4 L and T3 L. However, the better specificity of TSH ICMA and a smaller overlap with the frank hyperthyroid zone in patients with non-thyroid disease argue in favour of the use of this new assay method.

Aged↗
PubMed1990

In vitro and in vivo effects of increased concentrations of free fatty acids on free thyroxin measurements as determined by five assays.

To compare in vitro and in vivo effects of increased concentrations of free fatty acids (FFA) on free thyroxin (FT4) values, we measured FT4 in three pooled sera supplemented with oleate and in serum from 18 euthyroid patients before and after an infusion of fat emulsion (Intralipid). We used five FT4 RIA kits: two two-step methods [Gammacoat, Baxter (GC); Ria-gnost, Behring (RG)], two analog RIAs [Amerlex-M, Amersham (AM); Coat-Ria, BioMérieux (CR)], and one kit with labeled antibodies [Amerlex-MAB*, Amersham (AA)]. In vitro, at the maximum oleate addition of 5 mmol/L, FT4 increased when measured by the GC and RG kits, decreased by the AM kit, and showed no significant change by the CR and AA kits. In vivo, post-Intralipid, FFA concentrations rose significantly and the FT4 changes agreed with the results of the in vitro experiments, except for the RG kit, for which FT4 increased in only nine patients. We conclude that in vitro oleate addition is useful to predict the in vivo effect of increased FFA on FT4 values; moreover, in serum from euthyroid subjects with high concentrations of FFA, FT4 analyzed with the CR or AA kits should better agree with normal results for thyrotropin than FT4 values measured with the other kits.

Chromatography, Gas↗
PubMed1988

[Disorders of plasma trace elements in diabetes. Relation to blood glucose equilibrium].

The influence of glycaemic control and diabetes characteristics on plasma concentrations of magnesium, zinc, copper, selenium, rubidium and bromine has been evaluated in 44 diabetics (30 insulin-dependent, 14 non insulin-dependent), and the results obtained were compared to those of 309 control subjects of the same mean age. Diabetics had reduced plasma magnesium concentrations (P less than 0.01) but normal erythrocyte magnesium levels. Plasma zinc and selenium concentrations were reduced, whereas those of copper were increased and those of bromine and rubidium were normal. Correlation between glycaemic control, evaluated by measurement of glycosylated haemoglobin levels, and each of the parameters studied was only demonstrated with magnesium in insulin-dependent diabetics (r = -0.561; P less than 0.02). No correlation was found with the other clinical or anthropometric characteristics of the diabetic patients studied. Diabetes seems to be associated with numerous abnormalities of plasma trace elements and magnesium, but the mechanism of these abnormalities has not yet been elucidated. A decrease in zinc and selenium concentrations and an increase in copper concentrations might be additional factors of atherogenicity.

Adult↗
PubMedDate not supplied

[Treatment and monitoring of primary hypothyroidism].

Treatment of primary hypothyroidism requires a long-term hormonal therapy with levothyroxine which restores a normal TSH value. In a series of 192 patients followed up for at least 3 years we tried to evaluate the variability of maintenance dosage and to analyse the factors predictive of replacement dosage. The L-T4 dosage varied from one individual to the other, from 0.6 to 3.2 micrograms/kg. The mean maintenance dosage (118 +/- 38 micrograms/day) was similar in men and women weight for weight, but it was higher in subjects aged under 60 and in those with Hashimoto's or congenital hypothyroidism. There is a positive linear relation between the equilibrium dose and the TSH value (n = 0.84; p < 0.001) and a negative relation with the L-T4 concentration (n = 0.71; p < 0.001). The yearly variation of dosage in each individual was small (about 3.5%) and of the same order as the variation of weight. We conclude that the L-T4 maintenance dosage depends on the cause of hypothyroidism, on the importance of biochemical abnormalities and on the patient's age, sex and weight. In practice, however, the necessary dosage is difficult to predict. In the equilibrium phase the need for replacements is remarkably stable. A yearly assay of baseline TSH seems to be sufficient to evaluate the quality of hormonal compensation in the absence of intercurrent events.

Adolescent↗